CategoryBlogging

Canadian Journal of Psychiatry: “Telepsychiatry 2.0”

‘Closed-circuit television has been introduced into the field of mental hygiene as a medium for the administration of therapy to a mass audience. The present evidence indicates that that the use of this type of television may promote the development of new and more effective methods for the treatment of the mentally ill.’ This hopeful statement appeared at the beginning of a 1957 peer-reviewed paper. Four years later, the potential of telepsychiatry ‘as a means of extending mental health services to areas that are remote from psychiatric centers’ was described. Six decades later, where are we?

So begins an editorial in the current issue of The Canadian Journal of Psychiatry.  I’ve co-authored the paper; Dr. David Goldbloom is the first author.

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Drawing on the Serhal et al. paper on telepsychiatry in Ontario, we consider the current state:

Consider: of the more than 48,000 people in need of psychiatric care (defined by the authors as psychiatric or primary care within a year after a psychiatric hospitalisation), fewer than 1% saw a psychiatrist through telepsychiatry—and 39% saw no psychiatrist. We note the marked contrast with the United States, where telepsychiatry has been rapidly growing.

And we consider how to move forward. We propose a four-point plan, including “a province-wide strategy that has defined clinical priorities, geographic rationales, and measured outcomes.”

You can find our editorial here:

http://journals.sagepub.com/doi/full/10.1177/0706743717714469

Note: open access.

Public Coverage for Evidenced-based Therapies for Depression and Anxiety?

Should there be public coverage for evidenced-based psychotherapies for major depressive disorder and generalized anxiety disorder? The Ontario Health Technology Advisory Committee recommended yes in a new draft paper, and gave comment on ways of doing this.

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The Committee asked for public feedback. In my submission, I noted: “The recommendations of the Ontario Health Technology Advisory Committee are reasonable and thoughtful.”

You can find my full submission here:

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Award of Excellence in Mental Health

Individuals in need of Cognitive Behavioral Therapy (CBT) typically face challenges like long wait lists, a shortage of therapists, and lack of access to a therapist outside of regular business hours. Now, adult outpatient clients of Scarborough and Rouge Hospital’s Mental Health department can access treatment for anxiety and depression any time and place that is most convenient for them.

My Scarborough and Rouge Hospital team was awarded the 2017 Award of Excellence in Mental Health and Quality Improvement from the Canadian College of Health Leaders.

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Our  team won this honour for our e-therapy work. The gala dinner was in Vancouver this Sunday.

Full details here: https://www.cchl-ccls.ca/site/awards_mentalhealth_quality

Nice.

Dr. Doug Weir on the tPSA

The following was written by Dr. Doug Weir, a psychiatrist and a former OMA President.

The Tentative Physician Services Agreement:
Why I Am Voting YES

by Dr. Doug Weir Continue reading

OMA Section on Psychiatry Position on tPSA

The OMA Section on Psychiatry emailed out the following statement. It’s unanimously approved.

I’ve attached the Tariff Analysis by Dr. Sonu Gaind. Dr. Gaind is the president of the Canadian Psychiatric Association.

Continue reading

Yes or No on tPSA

In the last few days, I’ve received more than a dozen emails and read a score of tweets – and that’s just from the two organized campaigns. As Ontario doctors get ready to weigh in on the Ontario government offer, there are many opinions being offered up.

I’ll disclose that I’m a member of the OMA’s Section on Psychiatry Executive.

How to cast your ballot on the three questions?

I’d like to focus on two letters that are relevant to Ontario psychiatrists. The goal here isn’t to lobby you but to help inform you.

The next two posts are worth reading and considering.

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Paper with an N of 14 Lands NYT Story

There is more to this story than a paper with a tiny sample of people — yes, just 14 — landing in The New York Times.

Benedict Carey is an excellent reporter and he looks at the Hearing Voices Network, which attempts to help people with psychosis without labels like patients. And without medications.

Benedict Carey

Here’s the link for “An Alternative Form of Mental Health Care Gains a Foothold”:

http://nyti.ms/2avgwX6

And, yes, the article closes by mentioning a Psychiatric Services paper with an n of 14.

Quick question: if we were talking about a group promoting, say, breast cancer treatment without chemo or radiation, would they have gotten so much attention?

A Podcast Worth Listening To

I’m a big fan of the National Elf Service — a nice collection of bloggers writing about the literature.

Recently, they have started doing Podcasts, and the project doesn’t disappoint.

There are several good Podcasts in the series, but I particularly like the interview with Oxford’s Willem Kuryken on mindfulness.

Kuryken, as you will recall, has been the first author of a couple of excellent new papers that I have been highlighted in the Reading of the Week. Here, he talks thoughtfully about the topic he knows best. There are good insights on depression and relapse prevention — and more.

https://soundcloud.com/national-elf-service/mindfulness-with-willem-kuyken

Willem Kurken

On The Night Table: The New Depression Guidelines

On the night table…

“Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder”

The CANMAT group’s latest work is published in The Canadian Journal of Psychiatry.

The full documents are now online first.

Find them here:

http://cpa.sagepub.com/content/early/recent

My sense after a first read? Excellent and practical.